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Dependent Care Flexible Spending Account (FSA) Worksheet

This worksheet can help you decide if you would benefit more from the Federal Child Care tax credit or from a Dependent Care FSA. It can also be used to determine an appropriate Dependent Care FSA election. For detailed tax rate information, consult your tax advisor.

Estimate Your Monthly Dependent Care Expenses

Infant/Toddler

Preschool (Kindergarten and above is not eligible)

Before and after school care

School Vacations/Holidays

Other Dependent care

Total MONTHLY Expenses

Total ANNUAL Expenses

Maximum Non-Taxable Expenses

$ 5,000.00

Annual household income

Number of children you claim on taxes

Number of qualifying dependents

Tax filing status

State in which you live

Estimated Annual Taxable Income

$ 0.00

Dependent Care FSA

* Estimated election or maximum allowed

$ 0.00

Additional amount you may take as Child Care Tax Credit

$ 0.00

Estimated Annual Tax Savings

$ 0.00

FEDERAL CHILD CARE TAX CREDIT

* Maximum you may include on taxes

$ 0.00

Estimated Annual Tax Savings

$ 0.00

* If your spouse earns less than this amount, or if your spouse is a full-time student or is disabled, please contact Allegiance for help in determining maximum election allowed.

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Flex

Dependent Care Flexible Spending Account (FSA) Worksheet

Dependent Care FSA

FEDERAL CHILD CARE TAX CREDIT